Doubts about success of national insurance scheme

Some participants in a roundtable discussion in Accra have expressed doubts about the successful implementation of the proposed National Health Insurance Scheme as proposed by the NPP government in its manifesto during the 2000 general elections.

The participants said the “national” character of the proposed scheme may be too complex and difficult to operate. One participant even ventured to say that no “national” health insurance scheme has ever worked successfully anywhere in the world.

They agreed that health insurance projects could start on sectorial basis- like farmers, teachers, civil servants, having their own professional insurance schemes-and suggested that a health insurance scheme based on those of the Nkoranza and Dangme West areas could be emulated for a start.

Some medical experts at the roundtable said certain parameters need to be considered before considering a National Health Insurance Scheme. These parameters include the enforcement of an “effective free primary health care, followed by good infrastructure services like good roads, clean water, good sanitation practices.”

One contributor said no matter how best the health insurance scheme is put in place, if an accident victim or a labouring pregnant woman is unable to be rushed to a clinic because of inaccessible road, then the scheme would be a sham.

Many contributors wondered why the Social Security and National Insurance Trust (SSNIT) has no provision to cater for health insurance. Some even asserted that the funds from SSNIT contributors are for them and that government should amend the law governing SSNIT operations to enable beneficiaries have more benefits such as health insurance scheme.

A foreign research fellow who was in Ghana added his voice to a suggestion that women in the poor and disadvantaged areas of the country, especially northern Ghana, should be given adequate education to enable them appreciate the value of good healthy life and the need for proper healthcare.

On funding of the health insurance scheme, opinions were divided on how to cater for the informal sector, which is large, diverse and uncoordinated. Experts from the insurance industry were highly critical of the proposals enshrined in the “Policy Framework for the Establishment of Health Insurance in Ghana”, which is a Ministry of Health and Danish Development Agency (DANIDA) collaborative effort.

An executive summary of the policy framework states, among other things, that the Government intends to replace the Cash and Carry System with a Health Insurance Scheme that would improve financial access to healthcare in the country. The policy framework is intended to provide the general direction for the implementation of the scheme.